Provider Demographics
NPI:1891715538
Name:ADAMS, GEORGE HANCOCK NUTT (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:HANCOCK NUTT
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 E BOOT RD
Mailing Address - Street 2:BUILDING 300A
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5300
Mailing Address - Country:US
Mailing Address - Phone:610-431-0233
Mailing Address - Fax:
Practice Address - Street 1:1450 E BOOT RD
Practice Address - Street 2:BUILDING 300A
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5300
Practice Address - Country:US
Practice Address - Phone:610-431-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009294E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005507520001Medicaid
PA0026279000OtherPERSONAL CHOICE
PAC27484Medicare UPIN
PA0005507520001Medicaid